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Show PAGE Lange 6 ity Netus DECEMBER 9, 1994 *¢ DIALOGUE ENCE RM O@ UEN ON TOA HEALTH TN HEAET YH. CARE “ARE Health Care Reform: Where Did 0? Is It Coming Back? Legislative proposals will focus on preserving parts of the sys-tem that work well and target- ing specific areas which need reform. STEVE KOHLERT _ Americans felt TINCaA CAN aaron SENIOR VICE PRESIDENT INTERMOUNTAIN HEALTH CARE canal BNO Maus hy did federal health care reform initiatives break down this year? How will this breakdown affect health care in readers have called in asking these questions. - Market pressures are bringing costs into line. Medical infla- tion has dropped to around five percent annually. The rate still shortcomings of our system, process in our nation’s capital. finding consensus on specific According to these experts, federal health care reform broke down this year for a number of remedies is extremely challeng- reasons. 1. ABIG TASK AND A SHORT . _ DEADLINE When the president decided to tackle health care reform, no one fully realized how complex and difficult it would be. Although most Americans seemed to agree on broad: philosophical ing. 2. PERCEPTIONS OF AN EXCLUSIONARY PROCESS The process of drafting the administration’ reform legislation was perceived as exclusionary by critics. Ira Magaziner, the White Houses point person, organized more than 60 teams who worked to - develop solutions in a very short time frame. While the issues, legislators and -effort involved many racarnel their constituents brilliant minds and HOH TMU) | struggled with specific a staan ari sought public comproposals. Everyone SIR ment, there was not agreed health care enough time to foscosts were increasing =; ownership in tae ter a wide sense of far too fast and various | ownership in the populations were plan. Crities clearly falling through 3. POLITICS Like it or not, the American legislative process is political. Each party wants the credit for good outcomes. Not only is it critical for political forces to compromise; legislators also need consensus on the basic principles to serve as the foun- _dation for legislation. The need for reform was articulated, but the American peo- ple never reached consensus on the principles. Is basic ‘ health care a right? What price are we willing to pay for basic coverage for all? What are acceptable methods of financing coverage? Are certain limits to access acceptable if we cannot afford it all? Do we take a shotgun approach and reform everything, or do we take a rifle approach and f. OUR VIEW OF GOVERNMENT Regardless of political affiliation, Americans tend to be dis- trustful of government and _ skeptical of the governments © ability to manage programs and enterprises. Much of the debate focused on the role of government in a reformed health system. The administra- tion said the proposed legislation would not represent a dra- matic enlargement of governments role in health care, and _ critics said the opposite. Consequently, Americans felt - uncertain about the level: of government involvement, and this proved a major obstacle to widespread support. WHERE DO WE GO FROM HERE? Health care reform will be on the national agenda again in the cracks, but to reform a sev- accused the administration of focus on specific issues? As 1995. A number of experts enth of the national economy working behind closed doors and of excluding input from those with practical, day-to-day experience in health care. individuals and as a nation, Americans never came to grips with these basic—and have said the White House and Congress will attempt reforms that are less sweeping than the legislation proposed this year. in a hundred days proved too tall an order. We learned that while its easy to point out the Doctors, hospitals, and insurance companies are reconfiguring themselves and working together to meet the. needs of their customers (consumers and businesses). the Intermountain area? Many The following IHC Dialogue column is based on insights from a number of health care experts who were close to the It is important to remember that considerable reform has already taken place in the marketplace. _extremely thorny—issues. needs to drop, but this is a major shift from the days of double-digit increases. While federal reform has stumbled, state-and local initiatives are continuing to move for- ward. For example, a number of legislative efforts are underway in the Intermountain West which will address specific issues such as insurance reform. We believe the national discussion on health care has been good for all parties involved. We see no cause for discouragement. Progress is still progress, whether it comes incrementally or all at once. Please call or write if you would like to see other issues addressed in this column. THC DIALOGUE ON HEALTH CARE 36 South State Street Salt Lake City, Utah 84111 1-800-889-3337 INTERMOUNTAIN HEALTH IHC CARE 16 |